This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
"This book helps readers understand the principles of medical record documentation and chart auditing. It introduces readers to principles of medical record documentation and how to conduct a medical record chart review in the physcian's or outpatient office"--Provided by publisher.
Author: United States. Congress. Senate. Committee on Appropriations. Subcommittee on Departments of Labor, Health and Human Services, Education, and Related Agencies
An invaluable tool equipping healthcare professionals, auditors, and investigators to detect every kind of healthcare fraud According to private and public estimates, billions of dollars are lost per hour to healthcare waste, fraud, and abuse. A must-have reference for auditors, fraud investigators, and healthcare managers, Healthcare Fraud, Second Edition provides tips and techniques to help you spot—and prevent—the "red flags" of fraudulent activity within your organization. Eminently readable, it is your "go-to" resource, equipping you with the necessary skills to look for and deal with potential fraudulent situations. Includes new chapters on primary healthcare, secondary healthcare, information/data management and privacy, damages/risk management, and transparency Offers comprehensive guidance on auditing and fraud detection for healthcare providers and company healthcare plans Examines the necessary background that internal auditors should have when auditing healthcare activities Managing the risks in healthcare fraud requires an understanding of how the healthcare system works and where the key risk areas are. With health records now all being converted to electronic form, the key risk areas and audit process are changing. Read Healthcare Fraud, Second Edition and get the valuable guidance you need to help combat this critical problem.
Clinical audit is at the heart of clinical governance. Provides the mechanisms for reviewing the quality of everyday care provided to patients with common conditions like asthma or diabetes. Builds on a long history of doctors, nurses and other healthcare professionals reviewing case notes and seeking ways to serve their patients better. Addresses the quality issues systematically and explicitly, providing reliable information. Can confirm the quality of clinical services and highlight the need for improvement. Provides clear statements of principle about clinical audit in the NHS.
Master advanced coding skills! Buck's The Next Step: Advanced Medical Coding and Auditing shows how to code for services such as medical visits, diagnostic testing and interpretation, treatments, surgeries, and anesthesia. Real-world cases (cleared of any patient identifiers) takes your coding proficiency a step further by providing hands-on practice with physician documentation. With this guide, you'll learn to pull the right information from medical documents, select the right codes, determine the correct sequencing of those codes, and properly audit cases. - Real-world patient cases (cleared of any patient identifiers) simulate the first year of coding on the job by using actual medical records, allowing students to practice coding with advanced material. - UNIQUE! Evaluation and Management (E/M) audit forms include clear coding instructions to help reduce errors in determining the correct level of service. - More than 150 full-color illustrations depict and clarify advanced coding concepts. - From the Trenches boxes highlight the real-life experiences of professional medical coders and include photographs, quotes, practical tips, and advice. - NEW! Coding updates include the latest information available, including 2022 code updates when released. - NEW! Coverage of CPT E/M guidelines changes for office and other outpatient codes.
Master advanced coding skills! Buck's The Next Step: Advanced Medical Coding and Auditing shows how to code for services such as medical visits, diagnostic testing and interpretation, treatments, surgeries, and anesthesia. Real-world cases (cleared of any patient identifiers) takes your coding proficiency a step further by providing hands-on practice with physician documentation. With this guide, you'll learn to pull the right information from medical documents, select the right codes, determine the correct sequencing of those codes, and properly audit cases. - Real-world patient cases (cleared of any patient identifiers) simulate the first year of coding on the job by using actual medical records, allowing you to practice coding with advanced material. - UNIQUE! From the Trenches boxes highlight the real-life experiences of professional medical coders and include photographs, quotes, practical tips, and advice. - UNIQUE! Evaluation and Management (E/M) audit forms include clear coding instructions to help reduce errors in determining the correct level of service. - Over 170 full-color illustrations depict and clarify advanced coding concepts.